How Medicare EasyClaim Works
A summary of the Medicare EasyClaim process in different scenarios.
Accounts paid in full
- After the patient/claimant pays their account (using cash, credit card or EFTPOS), their Medicare card details are automatically transmitted from MedicalDirector Pracsoft.
- MedicalDirector Pracsoft sends the claim details to Medicare Australia for verification. The claim is checked and an approval is sent back a few seconds later.
- The patient/claimant then swipes their EFTPOS card through the EFTPOS / Easyclaim terminal, enters their PIN and their rebate is paid into their nominated cheque or savings account on the same day.
- Practice staff give the patient/claimant an EFTPOS receipt to confirm their rebate has been paid. Important: Easyclaim rebates can only be deposited into cheque or savings account.
Unpaid or partially paid accounts (rebates obtained by Medicare Online)
- Medicare card details are automatically transmitted from Pracsoft.
- The claim is checked and claim submission is accepted or declined instantly. A cheque made out to the health service provider is posted to the patient/claimant within 14 days.
- When the patient/claimant receives the cheque, they will send it to the health service provider along with any other outstanding balance payment.
Bulk billing
- If the patient is bulk billed, the patient will press a button on the EFTPOS keypad to assign their benefit to the health service provider. No signature is required.
- The Claim and patient Medicare card details are automatically transmitted from Pracsoft.
- Claim is checked and approval is sent within seconds.
Large Practice Bulk Bill (optional)
- Patient presents to Reception and OPV/OCV check is performed.
- Administrative staff print a DB4 form and attach it to the patient file if desired.
- Patient has consultation with the Practitioner who completes the DB4 form and has the patient sign.
- Administrative staff collect the DB4 form(s) and process claims through Medicare Easyclaim at a later time. Consider also Medicare rulings regarding this.